Evaluation of 'New Shift' Interventions Question Title * 1. Facility Name: OK Question Title * 2. 6-digit CCN# OK Question Title * 3. First and Last Name: OK Question Title * 4. Email Address: OK Question Title * 5. On a scale from 1 (not effective) to 3 (very effective), how effective was the New Shift Root Cause Analysis (RCA) tool on helping your facility identify barriers to home therapy referrals and cause(s) of the disparity gap? 1 - Not effective 2 - Somewhat effective 3 - Very effective N/A - Did not complete the RCA OK Question Title * 6. On a scale from 1 (not effective) to 3 (very effective), please rate the effectiveness the MEI Dialysis Decision Aid had on engaging patients--eliciting patient values and opinions and beliefs about home therapies? 1 - Not useful/not effective, will not recommend 2 - Somewhat useful/effective, would possibly recommend 3 - Very useful, would definitely recommend N/A - Did not utilize/test the MEI Dialysis Decision Aid Optional: Please add additional comments on the effectiveness/ineffectiveness of the MEI Dialysis Decision Aid. OK Question Title * 7. On a scale from 1 (not effective or useful) to 3 (very effective or useful), how effective was the Deep Dive Disparity Report on helping you/your staff to understand the disparity gap and identify eligible patients of the disparate group in your facility? 1 - Not useful/not effective, would not recommend 2 - Somewhat useful/effective, would possibly recommend 3 - Very useful, would definitely recommend N/A - Did not utilize/complete the Deep Dive Disparity Report Optional: Please add additional comments on the effective/ineffectiveness of this intervention. OK Question Title * 8. On a scale from 1 (not effective) to 3 (very effective), how effective was the Shift to Home podcast on encouraging your patients to seek more information on home therapies and/or dispel home therapy myths? (If N/A, select all N/A options that apply) 1 - Not effective 2 - Somewhat effective 3 - Very effective N/A - Never listened to the podcast N/A - Never shared the podcast with patients N/A - Never elicited patients' feedback on the effectiveness/use of podcast Optional: Please add additional comments on the effectiveness of the Shift to Home podcast. OK Question Title * 9. On a scale from 1 (not effective) to 3 (very effective), how effective were the Sustainability Action Plan questions on helping your staff develop an actionable plan to sustain patient engagement, overall home therapy referrals, and disparity gap reduction? 1 - Not effective, will never review my facility's action plan again 2 - Somewhat effective, will consider using/reviewing in the future 3 - Very effective, will continue to use the action plan in some capacity in the future N/A - Did not complete the Sustainability Action Plan Optional: Please add additional comments on the effectiveness of the Sustainability Action Plan. OK Question Title * 10. On a scale from 1 (not beneficial) to 3 (very beneficial), how beneficial was it to share and present on "best practices" during the #ENGAGE Campaign outcomes webinar? Example: It was beneficial because I was able to establish new ways to promote home therapies based on what my peers presented during the #ENGAGE Campaign outcomes webinar. 1 - Not beneficial, I did not learn anything new from the facility presentations 2 - Somewhat beneficial, I may have learned something new 3 - Very beneficial, I learned something new and have/will consider implementing what I learned during the facility presentations N/A - No facility staff were present on the #ENGAGE Campaign facility outcomes webinar OK Question Title * 11. On a scale from 1 (not effective) to 3 (very effective), please rate the effectiveness the "Disparities in ESRD" webinar facilitated by Dr. Deidre Crews, had on improving you/your staff's understanding of health equity and disparities in ESRD. 1 - Not effective 2 - Somewhat effective 3 - Very effective N/A - Did not attend the "Disparities in ESRD" webinar Optional: Please add additional comments on the effectiveness/ineffectiveness of the "Disparities in ESRD" webinar. OK Question Title * 12. On a scale from 1 (not beneficial) to 3 (very beneficial), how beneficial were the monthly facility feedback reports in helping your facility identify areas for improvement and engage in rapid cycle improvement? 1 - Not beneficial 2 - Somewhat beneficial 3 - Very beneficial N/A - I don't review or read the facility feedback report Optional: Please offer input on ways the feedback report can be improved. OK Question Title * 13. On a scale from 1 (not useful) to 3 (very useful), please rate the usefulness the MATCH-D Tool had on helping staff identify eligible patients for home therapies. 1 - Not useful 2 - Somewhat useful 3 - Very useful N/A - Did not use or test MATCH-D Tool Optional: Please add additional comments on the usefulness of the MATCH-D Tool. OK Question Title * 14. Rank the following interventions from 1 to 7 (1 being the most effective intervention; 7 being the least effective intervention) based on how effective they were to increasing home therapy consultations/referrals made throughout the New Shift initiative? 1 2 3 4 5 6 7 MEI Dialysis Decision Aid 1 2 3 4 5 6 7 New Shift Podcast 1 2 3 4 5 6 7 MATCH-D Tool 1 2 3 4 5 6 7 Deep Dive Disparity Report 1 2 3 4 5 6 7 "Disparities in ESRD" webinar 1 2 3 4 5 6 7 Root Cause Analysis (RCA) 1 2 3 4 5 6 7 #ENGAGE Campaign OK Question Title * 15. How easy and convenient was it to complete and submit monthly home referral data via fax? Please note that patient-level data (PHI, PII) cannot be shared via email. Easy and convenient Somewhat easy and convenient, but would prefer another method for submitting monthly data Difficult and cumbersome, would definitely prefer another method for submitting monthly data If you selected an answer other than "easy and convenient," please share your preferred method for monthly home referral data submission. OK Question Title * 16. Rank the following interventions from 1 to 7 (1 being the most effective intervention; 7 being the least effective intervention) based on how effective they were in helping to reduce the disparity gap in your facility ? 1 2 3 4 5 6 7 MEI Dialysis Decision Aid 1 2 3 4 5 6 7 New Shift Podcast 1 2 3 4 5 6 7 MATCH-D Tool 1 2 3 4 5 6 7 Deep Dive Disparity Report 1 2 3 4 5 6 7 "Disparities in ESRD" webinar 1 2 3 4 5 6 7 Root Cause Analysis (RCA) 1 2 3 4 5 6 7 #ENGAGE Campaign OK Question Title * 17. Which of the following interventions will your facility continue to utilize to help promote home therapies and/or challenge disparities (Select all that apply): MEI Dialysis Decision Aid New Shift Podcast MATCH-D Tool Deep Dive Disparity Report Sustainability Action Plan None Other (please specify) OK SUBMIT EVALUATION